Difficult Procedures: The Knick is a Bleak Look at Medicine and Society in the Industrial Era

It’s a testament to the weird way my brain works that the first thing I notice about Steven Soderbergh’s new show The Knick is that it starts almost exactly like the scene introducing Johnny Depp’s Inspector Abberline in From Hell, the world’s second worst Alan Moore adaptation. Clive Owen is replacing Johnny Depp, Lodon is switched out for New York, the opium is now coke, and the sex workers this time out are vaguely Asian rather than Heather Graham, but the point seems to basically be the same: here is your anti-hero, a functioning drug addict, can you believe this man is supposed to save the day? Luckily The Knick is already a far better work in its pilot than From Hell ever managed to be, and a lot of that has to do with the way Clive Owen allows himself to be depicted as a decidedly unsexy asshole with an ego that’s as problematic as what he’s pumping into his veins. It doesn’t hurt that The Knick is also far more willing to depict the brutal horror of life right around the start of the 20th century than From Hell the film was.

That latter aspect is front and center basically from the start, as Owen’s Dr. John Thackery is woken from his coke induced slumber in order to take part in an experimental operation on a pregnant woman. Anyone familiar with From Hell the comic knows that Eddie Campbell’s art in the series is what truly brought its horror to life, depicting scenes of evisceration and surgery in basically the same gory, abstract light and there’s a curious connection between The Knick and Campbell’s style. Soderbergh and crew depict the surgeries of The Knick in what seems to be a basically accurate way, but where they get more abstract is in their focus on the mess a body becomes on the operating table. The first, tragic operation in The Knick is as notable for the gallons of almost black blood pouring out from the woman’s stomach and the grey, fluid covered baby that is pulled out of her as the interaction between Thackery and his mentor Dr. Christianson (Matt Frewer). Unlike other historical dramas that want you to romantically look back at another era, The Knick is hellbent on reminding the viewer that life was vicious and brutal and disgusting in the industrial era– here is an operating room where there are no gloves, no real sterilization, just brave medical staff utilizing terrifying tools to try to get bodies they barely understand under control.

The nonstop brutality on display goes a long way towards explaining (but not excusing) Thackery’s addiction. Even though death was more frequently a certainty in the operating room at the time, that didn’t make the loss of patients any easier on the doctors, and it’s not too surprising that Dr. Christianson takes his own life immediately after we witness the botched operation. Meanwhile Thackery perseveres through coke and meanness, whether that’s manifesting in an egomaniacal eulogy at Christianson’s funeral or his demand that a nervous new nurse give him a shot of coke in the dick towards the end of the episode. Soderbergh and writers Jack Amiel and Michael Begler also seem interested in exploring narcotics as a direct influence on Thackery’s brilliance, with coke providing a boost to Thackery’s energy and drive, but also the explanation behind his mentor’s haunting presence in his life after death. This isn’t a sexy drug story, it’s an intimate examination of the paradox of the drug addict experience: they want the drugs to make the pain go away and provide them with creative energies they can’t control, but they also want to shake the new pains and experiences it brings in.

Stylistically and narratively The Knick may seem at odds with most of Soderbergh’s ouevre, but there’s a lot of Soderbergh’s other drug ballad Traffic in The Knick, from its dusty color palette to its shifting narrative. Thackery is undoubtedly the main attraction here, but the show also offers up tantalizing glimpses at the cutthroat world of early ambulance drivers, a rogue nun giving questionable midwife advice to ailing mothers in the hospital and Thackery’s archnemesis, the boldly progressive Cornelia Robertson (Juliet Rylance). Where Mad Men often places viewers in the trap of supporting “charming” misogynists, The Knick provides a world full of sexist, racist white men and robs them of almost all charm– that’s not to say that Thackery isn’t an enjoyable character, but The Knick admirably sticks to exploring the juxtaposition between a man’s progressive brilliance in his technical field and the unfortunately backwards thinking he displays socially, which seems all the more vile given our historical hindsight. As Thackery is attempting to stave off death in the operating room, he’s also attempting to hold back the progression Robertson symbolizes and the “hobby” she has taken on with Dr. Alergnon Edwards (Andre Holland).

Dr. Edwards is a promising young black doctor with an impeccable background who Robertson is demanding be given the deputy chief surgeon position at the hospital and Robertson isn’t above using her family’s funding of the hospital as blackmail to make it happen. What’s even more interesting is that the show makes it clear that Robertson is well aware that her power is borrowed– her father is ailing and thus unable to sit in on board meetings, so she’s acting on his behalf. Her fellow board members have an obvious dislike and mistrust of Robertson and rather than attempt to win them over, she continuously reminds them that their precarious financial position is only salvageable if they put aside their sexist notions of women in the workplace. But Roberston isn’t interested in playing it carefully, so she maximizes her borrowed power, using it not just to advance her own position but to also force a step towards racial equality. Edwards, however, is less comfortable with this transfer of power and is visibly uneasy with the treatment he receives in the hospital even before he explicitly says as much. For Edwards, there is no tycoon father to lean back on, no lights to figuratively and literally turn off if he doesn’t get his way. Instead he initially refuses to function like a Jackie Robinson of surgeons, stoically facing the scorn, insults and hate thrown his way by peers; he’d rather just go back to Europe, where he’s at least treated more civilly.

Curiously, the other historical medical drama on basic cable right now, Masters of Sex, is also exploring the collisions between progressive technical experimentation in medicine and the slower moving social progression of the doctors experimenting. In its second season, Masters of Sex has ramped up its commentary on racial and gender politics in hospitals not just through more storylines set in the medical world but also in Dr. Masters’ own home, as his wife Libby attempts to exert her own power by treating her black nanny as a kind of pet, forcing her to learn to behave and speak “properly” while also attempting to erase her cultural identity. There’s a chance The Knick will explore similar ground, as Dr. Edwards only gives in to sticking with his hostile work environment in order to learn from the bullying Dr. Thackery, which could lead to a similar erasure of identity as the season carries on. That could eventually be a storyline that’s as brutal and depressing as the close ups on dying mothers and infants and intestinal fuck-ups and given Traffic’s own depiction of race in the drug war, it’s bound to be a refreshing treatment of the situation. Like the slum tenants who get a subplot in the pilot, Thackery may not realize that being forced into a new environment is ultimately for his own, but the 20th century and progress are coming whether he wants them to or not.

Morgan Davis sells bootleg queso on the streets of Austin in order to fund Loser City. When he isn’t doing that, he plays drums for Denise and gets complimented and/or threatened by Austin’s musical community for stuff he writes at Ovrld, which he is the Managing Editor of.